Impact of hormonal treatment duration in combination with radiotherapy for locally advanced prostate cancer: Meta-analysis of randomized trials

<p>Abstract</p> <p>Background</p> <p>Hormone therapy plus radiotherapy significantly decreases recurrences and mortality of patients affected by locally advanced prostate cancer. In order to determine if difference exists according to the hormonal treatment duration, a literature-based meta-analysis was performed.</p> <p>Methods</p> <p>Relative risks (RR) were derived through a random-effect model. Differences in primary (biochemical failure, BF; cancer-specific survival, CSS), and secondary outcomes (overall survival, OS; local or distant recurrence, LR/DM) were explored. Absolute differences (AD) and the number needed to treat (NNT) were calculated. Heterogeneity, a meta-regression for clinic-pathological predictors and a correlation test for surrogates were conducted.</p> <p>Results</p> <p>Five trials (3,424 patients) were included. Patient population ranged from 267 to 1,521 patients. The longer hormonal treatment significantly improves BF (with significant heterogeneity) with an absolute benefit of 10.1%, and a non significant trend in CSS. With regard to secondary end-points, the longer hormonal treatment significantly decrease both the LR and the DM with an absolute difference of 11.7% and 11.5%. Any significant difference in OS was observed. None of the three identified clinico-pathological predictors (median PSA, range 9.5-20.35, Gleason score 7-10, 27-55% patients/trial, and T3-4, 13-77% patients/trial), did significantly affect outcomes. At the meta-regression analysis a significant correlation between the overall treatment benefit in BF, CSS, OS, LR and DM, and the length of the treatment was found (p≤0.03).</p> <p>Conclusions</p> <p>Although with significant heterogeneity (reflecting different patient' risk stratifications), a longer hormonal treatment duration significantly decreases biochemical, local and distant recurrences, with a trend for longer cancer specific survival.</p

‘A Girl's Love’: Lord Alfred Douglas as Homoerotic Muse in the Poetry of Olive Custance

This is an Accepted Manuscript of an article published by Taylor & Francis in Women: a Cultural Review on 15/09/2011, available online: http://dx.doi.org/10.1080/09574042.2011.585045.This article explores the relationship between the poet Olive Custance and her husband Lord Alfred Douglas, arguing that Custance constructed Douglas as a male muse figure in her poetry, particularly the sequence ‘Songs of a Fairy Princess’ (Rainbows 1902). The introduction sets out Custance's problematic historical positioning as a ‘decadent’ poet who published nothing following the Great War, but whose work came too late to fit into strictly ‘fin de siècle’ categories. I suggest, however, that Custance's oscillating constructions of gender and sexuality make her more relevant to the concerns of modernity than has previously been acknowledged and her work anticipates what is now termed ‘queer’. The first main section of the article traces the cultural background of the fin de siècle male muse, arguing that Custance's key influences—male homoerotic writers such as Wilde and Pater—meant it was logical that she should imagine the muse as male, despite the problems associated with gender-reversals of the muse-poet relationship which have been identified by several feminist critics. I then move on to focus specifically on how Shakespearean discourses of gender performance and cross-dressing played a key role in Custance and Douglas's courtship, as they exchanged the fluid roles of ‘Prince’, ‘Princess’ and ‘Page’. The penultimate section of the article focuses on discourses of fairy tale and fantasia in Custance's ‘Songs of a Fairy Princess’ sequence, in which these fantasy roles contribute to a construction of Douglas as a feminised object, and the relationship between the ‘Prince’ and ‘Princess’ is described in terms of narcissistic sameness. My paper concludes by tracing the demise of Custance and Douglas's relationship; as Douglas attempted to be more ‘manly’, he sought to escape the role of object, resulting in Custance losing her male muse. But her sexually-dissident constructions of the male muse remain important experiments worthy of critical attention

Gertrude and Ernest

Covers familiar biographical ground on Hemingway\u27s relationship with his mother, World War I wounding, interest in gender and sexual identity, early apprenticeship with Gertrude Stein, and their later break